This Groundbreaking Letter From Dozens of Sheriffs and DAs Calls for MAT in Jails

    Lack of access to methadone and burprenorphine, lifesaving opioid use disorder medications, for vulnerable incarcerated populations has long been a stain on the US criminal justice system.

    On April 3, a groundbreaking open letter—signed by 58 current or former elected sheriffs, district attorneys and other law enforcement and criminal justice officials and leaders from across the US—called for this situation to end in jails and prisons, and for naloxone distribution on release.

    Incarcerated populations are hugely important in the context of addressing the opioid-involved overdose crisis. A 2018 CDC report indicated that in around 10 percent of overdose deaths, there was evidence of the person being released from an institutional setting in the month prior.

    Law enforcement voices have the potential to be powerful influences on mainstream and government opinion. The letter was organized by Fair and Just Prosecution and the Law Enforcement Action Partnership (LEAP)*, two pro-reform advocacy groups.

    “For too long we have tried to punish people into abstaining from drugs rather than expanding access to strategies that work,” said Miriam Krinsky, executive director of Fair and Just Prosecution. “Requiring people to be cut off from medically assisted treatment while in custody flies in the face of proven best practices and increases fatal overdoses when people reenter the community. It’s time for a different way forward.”

    “Society demands that [jails] also serve as a hospital, mental health institution, school and rehabilitation center,” said Richard Van Wickler, Superintendent of the Cheshire County Department of Corrections in New Hampshire and a speaker for LEAP. “Providing adequate and responsible healthcare to treat addiction through medication-assisted treatment is a requirement, not an option.”

    “A prosecutor’s role does not end at the prison door,” said signatory Sarah George, Chittenden County State’s Attorney. “We are obligated to use our voices to ensure in those instances when people absolutely must be incarcerated, they leave custody in a position to safely reenter their communities.”

    As Filter has reported, a few encouraging signs of increased MAT availability for incarcerated people have emerged in recent months—with a federal judge in Massachusetts ruling in favor of a defendant receiving methadone, and a pilot program for injectable burprenorphine announced by Pennsylvania’s Department of Corrections. It is to be hoped that the new letter will increase this momentum.

    Here is the full text of the letter, which attorney and Filter contributor Rory Fleming played a role in drafting, with the full list of signatories below:


    As current and former elected local sheriffs and current elected prosecutors, as well as other law enforcement professionals, we are committed to protecting public safety and the safety of individuals in our custody. We believe that providing medication-assisted treatment (MAT) like methadone and buprenorphine in jails and prisons, as well as ensuring that individuals released from custody have naloxone and a continuing care plan, is part of that duty.

    Medical research shows that many people who are unable to stop illegally using opioids through abstinence-based treatment are able to stop when using methadone or buprenorphine as a part of medication-assisted treatment (MAT). While abstinence-based heroin treatment has a 5 to 15 percent long-term success rate, MAT program success rates exceed 50 percent. In addition, most people relapse at least once before they successfully enter recovery. People on MAT are much less likely to die of an overdose if they relapse.

    Decades of studies show that MAT use decreases illicit drug use, crime, and health costs to communities. Continuing MAT care in county jails and prisons is essential to ensuring that formerly incarcerated people do not relapse and reoffend upon release.

    Forcing people in jail to detox is difficult and dangerous. Withdrawal brings vomiting, diarrhea, and low blood pressure. People can die from dehydration while detoxing in jail—and a number have.

    Those forced to detox in jail or prison are also more likely to die from overdose upon release. According to a report last August by CDC researchers on overdose deaths, “Approximately one in 10 decedents had evidence of having been released from an institutional setting in the month preceding the fatal overdose . . . [T]he most common settings being jail, prison, or detention facilities when only illicit opioids were involved (4.9%). . . These data suggest a need . . . to expand treatment in detention facilities and upon release.” Fortunately, research shows that providing MAT in correctional facilities reduces the risk of overdose death post-release by 85 percent.

    In order to reduce overdose and improve recovery success, we also believe in ensuring that individuals struggling with addiction should be provided with naloxone and a continuing care plan upon release.

    We recognize that this epidemic of drug overdose requires a new approach. Over 70,000 Americans died from drug overdose in 2017, more than have ever died in a single year from the epidemics of crack cocaine, H.I.V., car crashes, or gun violence.

    We will work within our own jurisdictions to respond effectively to the new realities of the opioid crisis. By doing so, we will avoid needless fatalities, reduce the use of illicit opioids, and improve safety in our communities.


    Craig Apple
    Sheriff, Albany County, New York

    Branville Bard
    Commissioner, Cambridge Police Department, Massachusetts

    Sherry Boston
    District Attorney, DeKalb County, Georgia

    Patrick J. Cahillane
    Sheriff, Hampshire County, Massachusetts

    John T. Chisholm
    District Attorney, Milwaukee County, Wisconsin

    Jerry L. Clayton
    Sheriff, Washtenaw County, Michigan

    Brendan Cox
    Former Chief, Albany Police Department, New York

    John Creuzot
    District Attorney, Dallas County, Texas

    Satana Deberry
    District Attorney, Durham County, North Carolina

    Christopher J. Donelan
    Sheriff, Franklin County, Massachusetts

    Thomas J. Donovan, Jr.
    Attorney General, Vermont

    Michael Dougherty
    District Attorney, 20th Judicial District, Colorado

    Jay Fleming
    Former Deputy Sheriff, Park County, Montana

    Wendell France, Sr.
    Former Deputy Secretary, Department of Public Safety and Correctional Services, Maryland

    Kimberly Gardner
    Circuit Attorney, City of St. Louis, Missouri

    Sarah George
    State’s Attorney, Chittenden County, Vermont

    Sim Gill
    District Attorney, Salt Lake County, Utah

    Ed Gonzalez
    Sheriff, Harris County, Texas

    Mark Gonzalez
    District Attorney, Nueces County, Texas

    Christian Gossett
    District Attorney, Winnebago County, Wisconsin

    Andrea Harrington
    District Attorney, Berkshire County, Massachusetts

    Patrick Heintz
    Former Corrections Officer, Hampden County Sheriff’s Department, Massachusetts

    Pete Holmes
    City Attorney, Seattle, Washington

    Martin Horn
    Former Commissioner, Department of Corrections, Pennsylvania

    John Hummel
    District Attorney, Deschutes County, Oregon

    Kathleen Jennings
    Attorney General, Delaware

    Lawrence S. Krasner
    District Attorney, Philadelphia, Pennsylvania

    Karl A. Leonard
    Sheriff, Chesterfield County, Virginia

    Chris Magnus
    Chief, Tucson Police Department, Arizona

    James Manfre
    Former Sheriff, Flagler County, Florida

    Beth McCann
    District Attorney, Second Judicial District, Colorado

    Brian Middleton
    District Attorney, Fort Bend County, Texas

    Nick Morrow
    Former Detective and Deputy Sheriff, Los Angeles County Sheriff’s Department, California

    Marilyn J. Mosby
    State’s Attorney, Baltimore City, Maryland

    Peter Neronha
    Attorney General, Rhode Island

    Michael J. Neustrom
    Former Sheriff, Lafayette Parish, Louisiana

    John Padgett
    Former Sergeant, Richmond County Sheriff’s Department, Georgia

    David Parrish
    Former Jail Director, Hillsborough County Sheriff’s Office, Florida

    Joe Pelle
    Sheriff, Boulder County, Colorado

    Karl A. Racine
    Attorney General, District of Columbia

    Sue Rahr
    Former Sheriff, King County, Washington

    Carrie Roberts
    Former Corrections Officer, Department of Corrections, Colorado; Former Deputy Sheriff, Arapahoe County Sheriff’s Department, Colorado

    Rachael Rollins
    District Attorney, Suffolk County, Massachusetts

    Marian T. Ryan
    District Attorney, Middlesex County, Massachusetts

    Dan Satterberg
    Prosecuting Attorney, King County, Washington

    Carol A. Siemon
    Prosecuting Attorney, Ingham County, Michigan

    Mark Spawn
    Former Chief, Fulton Police Department, New York

    Norm Stamper
    Former Chief, Seattle Police Department, Washington

    Richard W. Stanek
    Former Sheriff, Hennepin County, Minnesota

    David E. Sullivan
    District Attorney, Northwestern District, Massachusetts

    Tom Synan
    Chief, Newtown Police Department, Ohio

    J. Scott Thomson
    Chief, Camden County Police Department, New Jersey

    Pete Tutmark
    Former Deputy Sheriff, Clackamas County Sheriff’s Department, Oregon

    Richard N. Van Wickler
    Superintendent, Cheshire County Department of Corrections, New Hampshire

    Cyrus R. Vance, Jr.
    District Attorney, New York County, New York

    Peter Volkmann
    Chief, Chatham Police Department, New York

    Andrew H. Warren
    State Attorney, 13th Judicial Circuit, Florida

    Scott Wriggelsworth
    Sheriff, Ingham County, Michigan

    *LEAP is the fiscal sponsor of The Influence Foundation, which operates Filter.

    Photo by Matthew Ansley on Unsplash

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